The Milwaukee Program: The Pediatric Complex Care Program (CCP) at the Children’s Hospital of Wisconsin (CHW) / Medical College of Wisconsin (MCW).


Objective: Describe the complex care program at the Children’s Hospital of Wisconsin, Medical College of Wisconsin – history, current structure, outcomes, research / quality improvement projects, and finances. 

History: Program started by Dr. John Gordon and Holly Colby, RN Program Manager in 2002.

Current Structure: Program serves ~650 CMC and their families through care coordination and medical co-management in both the ambulatory and inpatient environments. Team is composed of Care Coordination Assistant-RN dyad with the RN as the families’ main point of contact. Each patient also has a faculty physician or APNP serving in conjunction with the patient’s assigned dyad. Clinical Research Coordinator, Social Workers, and administrative staff support the program.

Outcomes: Favorable satisfaction ratings from families, primary care providers, subspecialty colleagues; cost savings identified by pre-post analysis.

Research: Primarily focused on program function, financial outcome, and clinical and family impact.

Finances: Hybrid value-volume based reimbursement structure.

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